All week I've been debating about homebirth or hospital birth for a VBAC. (kinda funny that it's only been a WEEK lol). I'm leaning strongly toward hospital, ONLY because there is a truly exceptional hospital here in Seattle (Group Health) that I have read about from more than a dozen women on MDC that it's a fantastic place to give birth. The nurses are hands off, the independent midwives are great, and it's a wonderful, 100% supportive VBAC environment. I am finally starting to feel more at peace about settling in that direction. I would love to homebirth...but feel like it's not right for us just yet (and insurance won't cover it) and really feel like I can go there in full confidence in having a supportive birth network.

Just wanted to share. Anyone else in the same boat?

Alicia, wife to an loving and faithful DH, and mama to three fantastic though nutty children (cs, then a fast HBAC, then a fast VBAC!!). Planning a third VBAC, again at home, in February 2016.

That's great! Also, it's good to know there will be someone else going for a VBAC around the same time as me. I'm from Seattle too, but have been on the East coast for 3 years. We're also doing a hospital VBAC. We live 5 minutes from a VBAC-banned hospital so I do not feel comfortable attempting one at home (DH is also against the idea of homebirth). I have also heard good things on MDC about the hospital I want to go to and the mw I want to see.

I had a hospital VBAC with my youngest DD, and am planning the same for this baby. It was the right decision for us last time, and I was very pleased with my treatment, so we'll be doing the same again.

HBACs are illegal in NJ Even thought I literally live across the street from a hospital. My midwives are both hospital and homebirth midwives so they do make the hospital experience the best it can be. My MW was in my hospital room with me last time for the 24 hours of labor there before birth. I'm not excited about another VBAC at all but thats another story. I guess I have some stuff to work through from my last.

I hope you mean that it's illegal for a midwife to attend a HBAC and not that it's illegal for a woman to have a HBAC. What would happen to a woman who accidentally had a HBAC? While there are many states where it is illegal, to varying degrees, for a midwife to attend a homebirth, I have not heard of any laws that make it illegal for a woman to give birth at home.

No, not anymore! Here's an article from MANA about ACOG's new guidelines released in July that say VBACs are safer than they previously thought and hospitals should honor them. Read specifically the 2nd paragraph... Thankfully for us we now have more options!!

Wife to John, Mom to Melanie (1/08), Deklan (5/09) and due April 11, 2011 & just started

No, not anymore! Here's an article from MANA about ACOG's new guidelines released in July that say VBACs are safer than they previously thought and hospitals should honor them. Read specifically the 2nd paragraph... Thankfully for us we now have more options!!

I didn't think so. I didn't think it was legal for a hospital or doctor to force someone to have surgery against their will, at least not without a court order. I was wondering if they could get away with it by referring women to another hospital that's just as convenient. Doctors can only refuse care if and when they refer a patient to another care provider who can and will provide the care desired.

Probably not, but it's a smaller hospital. I think that's the reason for the ban. The ACOG just changed the views on vbacs last month, but I haven't checked back on the hospital to see if the ban has been lifted. The only MW there is a b*&$# so I really don't want to go there.

Also, the article talks about "immediately available" staff if something were to go wrong and I'm not sure if this hospital has it. I took DD there for a high fever (above 103) and after 3 hours of waiting without seeing the doctor I took DD home. I have also heard someone refer to this hospital as the "not even if my dog was dying" hospital.

I'm trying for a hospital VBAC. What kills me is that there are 3 hospitals near me. The biggest one, doing 4500 births a year, does almost no VBACs. They have 24/7 OB and anesthesia, but the docs are in smaller private practices and don't want to hang around. The smaller community hospital, OTOH (1000 births a year) has a nice VBAC rate. The university hospital has an OK one (their overall CS rate is high, but they get lots of referral cases from the surrounding smaller hospitals). I have a theory that when the OBs rotate and HAVE to be there anyway, there's less incentive to just section and go home.

Probably not, but it's a smaller hospital. I think that's the reason for the ban. The ACOG just changed the views on vbacs last month, but I haven't checked back on the hospital to see if the ban has been lifted. The only MW there is a b*&$# so I really don't want to go there.

Also, the article talks about "immediately available" staff if something were to go wrong and I'm not sure if this hospital has it. I took DD there for a high fever (above 103) and after 3 hours of waiting without seeing the doctor I took DD home. I have also heard someone refer to this hospital as the "not even if my dog was dying" hospital.

I probably wouldn't want to go there even if they did change their policy. Obviously, someone there is hostile to VBACs. I feel that way about the civilian hospital here. If I could get into the naval hospital, I might consider birthing there but I'm told they are at capacity and can't take anyone new for anything. I know someone who was recently transferred from there to the civilian hospital because the naval hospital was full.

CookAMG, I met an awesome nurse last weekend during a yoga teacher training workshop who works at Seattle Group Health in L&D. They do have the lowest c-section rate in Seattle at 19% but even they admit it is still too high and are working to lower that. Group Health definitely sounds like the place to go from everything that I heard last weekend.

I don't think it is in our area but the civilian hospitals around here don't have outright bans. They just don't have any doctors who will take on a VBAC patient. It's a de facto ban. The one hospital around here that does have a VBAC doctor, he is so booked that it is hard to even get an appointment and from what I understand you can wait hours in the waiting room for 10 minutes with this guy. Ridiculous.

Lucky for me I have Tricare and they do VBACs in their hospitals.

><> I'm a Christian, knitting, sewing, cooking SAHM to the fearless adventurer Jack born 11/08, and a USCG wifeAnd we are joyfully awaiting a new addition in April 2011! <><

Oh, and if I indeed am pg (still waiting for my bfp) I'll be VBACing at the hospital on base. I'm pretty sure I'll be able to have a mw. I planned a HB the last time and ended up transferring...loong story, no fun. This time we just can't justify the expense of a direct-entry MW when we have the opportunity to VBAC with a MW in a military hospital for free. It's not ideal, but for now it's all we've got.

><> I'm a Christian, knitting, sewing, cooking SAHM to the fearless adventurer Jack born 11/08, and a USCG wifeAnd we are joyfully awaiting a new addition in April 2011! <><

Yep, cuz military hospitals and doctors don't make extra money from performing more surgeries, don't have any choice of being anywhere else until their shifts are over and can't get sued if something horrible happens. That's why I'd consider a VBAC at the Naval hospital here but no way would I do one at the civilian hospital. I did a hospital VBAC in 2004 at Tripler AMC in Honolulu. Aside from one annoying doc who assumed I was having a scheduled repeat c/s, no one had any problems with me doing a VBAC, induced no less. This was back when VBACs were frowned upon even more.

I'm amazed that doctors can get away with refusing care just because you want to do a VBAC. Seriously, legally, they cannot do that unless they can make sure you can get adequate care from someone else (in case anyone wants to go through the time and trouble to sue any of those docs ). I guess you could always pretend to go along with their VBAC plans but just not show up for the surgery and then appear at the hospital in labor and refuse surgery. I'm pretty sure they can't send you away unless they have somewhere else to send you.

I had to argue with the civilian docs I saw here while pg with ds3 about tha a little. They didn't like the idea of me doing a VBAC even though I had already had one. Since I wasn't actually planning to birth with them in the hospital anyway it wasn't that big of a deal.

I guess you could always pretend to go along with their VBAC plans but just not show up for the surgery and then appear at the hospital in labor and refuse surgery. I'm pretty sure they can't send you away unless they have somewhere else to send you.

according to the new AcOG guidelines, if you arrive at any hospital, even ones who do not allow abacus, they cannot force you to have a csection and they cannot refuse to treat you. They are required to honor your vbac wishes. As for OBs, an OB can transfer you away as a patient for any reason up until 36 weeks and they do not need to find someone to take over your care. However, after 36 weeks they can only transfer you out if they have found someone to take over your care. If you leave on your own, no one owes you anything and actually they can all blackball u if you want. But the hospital has to take you when u show up. Whatever dr is on call @ L&D that day will be your doc & must not force you into a section. What would be best if it came down to that would be to act like u were going to have a RCS and even schedule your date and then call the day of your section and say you changed your mind and just want to go naturally. And don't let them tell you that you don't have any other choices... But this would be an emotionally scarring experience I believe and should only be used as a last resort. Before you do that I would just try to find a vbac friendly dr or even better, a midwife. Mws will give you your best chance at vbac. I'm going for my vba2c myself and plan to deliver at home in the water. good luck!!!

Wife to John, Mom to Melanie (1/08), Deklan (5/09) and due April 11, 2011 & just started

I hope you mean that it's illegal for a midwife to attend a HBAC and not that it's illegal for a woman to have a HBAC. What would happen to a woman who accidentally had a HBAC? While there are many states where it is illegal, to varying degrees, for a midwife to attend a homebirth, I have not heard of any laws that make it illegal for a woman to give birth at home.

Yes, that's right. I had a really hard labor last time and would not want to UBAC. At ICAN we've talked about the possibility of a traveling midwife and I might be willing to go that route but I do my current MWs.

Yes, I imagine it would be very emotionally difficult to have to fight like that, especially while pg. I think it's horrible that docs put women in that position. The OB that I was seeing for dual care when I was pg with ds3 said he'd put my birth plan in his chart but the docs would decide what was best at the time. Uh, I don't think so. And, after someone at that practice found out I had him at home, s/he reported me to CPS as having 4 unknown children (I assume because I had had 3 very early miscarriages). It seemed like they were trying to make me look like a baby killer. He was born underwater, by the way.

I agree that, if it all possible, it's definitely better to see a midwife. If a midwife isn't available, then a VBAC supportive doc, even if it means you have drive a long distance or wait 2 hours.

Even in the most supportive hospital you just need to be sure that your OB is totally on board with your VBAC. Furthermore, beyond having a supportive OB and hospital staff, I'd still recommend that you consider hiring a doula. Sometimes unexpected mental blocks, emotions, or flashbacks crop up during a VBAC mama's labor. Doulas are good at helping you overcome those internal roadblocks that come up, even when the external ones have been removed. God bless you and I pray you have a successful VBAC!

Furthermore, beyond having a supportive OB and hospital staff, I'd still recommend that you consider hiring a doula. Sometimes unexpected mental blocks, emotions, or flashbacks crop up during a VBAC mama's labor. Doulas are good at helping you overcome those internal roadblocks that come up, even when the external ones have been removed.

Yep, cuz military hospitals and doctors don't make extra money from performing more surgeries, don't have any choice of being anywhere else until their shifts are over and can't get sued if something horrible happens.

This is good to know. I haven't had to deal with military hospitals to find out. Our MTF doesn't do emergency care and is constantly telling people to go to the nearby hospital if they can't handle something.